Transnasopharyngeal spray topical anesthesia with sedation for tracheobronchoscopy
Objective To test the effect,safety and feasibility of transnasopharyngeal spray topical anesthesia with deep sedation for tra-cheobronchoscopy.Method 60 patients undergoing tracheobronchoscopy were included and assigned equally into two groups by random number table:the thyrocricocentesis topical anesthesia group(Group C)and the nasopharyngeal spay topical anesthesia group(Group E)Patients in Group C were anesthetized by puncturing the trachea through the cricothyroid membrane after entering the room,and re-ceived nasal oxygen;Group E patients obtained tracheal surface anesthesia by induced cough through nasopharyngeal airway spraying,and oxygen was supported through nasopharyngeal airway.Both groups were sedated by intravenous propofol and remifentanil.When Ramsay scale is more than 4,fiberoptic bronchoscope was allowed to insert.The main outcome variable was the incidence of intraoper-ative hypoxemia in both groups;The secondary outcomes included mean arterial pressure and heart rate at time points such as preopera-tive(T0),puncture of the cricothyroid membrane or placement of the nasopharyngeal airway(T1),tracheobronchoscope reach the glottis(T2),reach the carina(T3),and the time awake(T4);supporting the lower jaw;tracheobronchoscope retraction;Total a-mount of lidocaine during surgery;surgery time;recover time;doctor convenience and patient satisfaction;dosage of propofol and remifentanil;incidence of cough score and other intraoperative complications including postoperative sore throat,nausea,vomiting,and nosebleed.Results Primary outcome:Compared with group C,the incidence of intraoperative hypoxemia was significantly reduced in Group E(P<0.05).Secondary outcome:there was no statistical difference in the total amount of lidocaine in the two groups(P>0.05);compared with group C,the number of jaw support and withdrawal decreased significantly(P<0.05);compared with group C,operation time was significantly shorter,doctor-patient satisfaction increased,and remifentanil was significantly decreased(P<0.05);the difference in recovery time,propofol dosage,cough score and postoperative complications were not statistically significant(P>0.05).Conclusion Transnasopharyngeal spray induced cough can achieve satisfactory topical anesthetic effects for tracheobron-choscopy.This technique can reduce the incidence of intraoperative hypoxemia,shorten the operation time,and improve the satisfac-tion of surgeons and patients.
NETL
NSTL
万方数据
